HEALTH SYSTEM RESPONSIVENESS AND ITS CORRELATES AT OUTPATIENT DEPARTMENT SERVICE IN DISTRICT GENERAL HOSPITAL, KALUTARA

Background: Patients desires on outpatient services at hospitals are varied, yet due to unexploring their needs resulting in patient dissatisfaction. Objectives: To assess the health system responsiveness and its correlates at out-patient department in District General Hospital, Kalutara. Methods: We conducted a cross-sectional descriptive study among 423 out-patients at District General Hospital, Kalutara in 2018, selected using a systematic sampling method. We included patients of age over 18 years, while excluded critically ill patients and the patients who repeatedly got selected for the study on their subsequent visits.We assessed the health system responsiveness under eight domains and collected data using an interviewer-administered questionnaire. Results: Response rate was 93.6% (n=396). The majority consisted of females (n=266, 67.2%). Responsiveness varied according to the each domain: confidentiality (56.8%), communication (56.1%), dignity (55.3%), quality of basic amenities (42.7%) and social support during care (41.4%). Further, most patients (n=324, 81.9%) didn't satisfy on waiting time at dispensary and total time spend for obtaining health care services (n=351, 88.6%). Females (p=0.01), elderly patients (p=0.000), being employed (p=0.000) and patients drew higher monthly income (p=0.000) were significantly less-satisfied with the overall services. Conclusions: Most patients have higher responsiveness to overall services. However, areas such as choice of care provider need to be implemented and prompt attention need further improvement. Strengthening the infrastructure and introducing an appointment system are recommended.